Question
What is the difference between limited and comprehensive OAEs?
Answer
The best way to answer this question is too look at the definitions for limited and diagnostic OAE procedures as described in CPT codes. Even after reading the CPT descriptions, there is still a need for some decision-making on the part of the audiologist. Clinically, it can be a bit of a subjective judgment based on the purpose of the testing. Are you doing a screening on an infant or adult with a screening or "Quick Screen" protocol with a limited number of frequencies (i.e. perhaps 5 or less frequencies) and only one intensity level? Does the testing only take about 5 minutes? If so, it could be considered limited OAEs. Are you doing a diagnostic test on a patient in order to find out about hearing thresholds and etiology of hearing loss, and OAEs are used as one of the many tests performed to gather diagnostic information? Are you using a protocol that is not set up just for screening, testing a wide range of frequencies (greater than 5 frequencies), and possibly changing the intensity level of stimuli to obtain more data? If so, this could be considered diagnostic or comprehensive OAEs. The diagnostic testing might take longer to complete (i.e. 20 minute).
According to the CPT(Current Procedural Terminology) Book: (The words screening and diagnostic below are italicized because the CPT book showed them in italics)
CPT Code: 92587 - Otoacoustic Emissions, Limited "Recording of TOAE or DPOAE using single stimulus level or for screening (e.g. newborn screening) purposes with interpretation and report. Time factor: PC=0 minutes, TC=5 minutes"
CPT Code: 92588 - Otoacoustic Emissions, Diagnostic "Recording of TOAE or DPOAE at multiple frequencies, levels, or conditions or for diagnostic purposes with interpretation and report. Enter one code regardless of the number of conditions tested. Time factor: PC=15 minutes, TC=10 minutes"
PC refers to the "Professional Component" and TC refers to the "Technical Component"
Rebekah Fallis Cunningham, Ph.D. is currently an Assistant Professor in the Department of Audiology at the Arizona School of Health Sciences. She is the Director of Clinical Education at ASHS and instructs residential as well as transitional students in a variety of topics, including OAEs, Evoked Potentials, Pediatric Audiology, Newborn Hearing Screening, Auditory Processing and Cochlear Implants. She has practiced privately and as the coordinator for the pediatric program at a large hospital. She has also worked at a Children's Hospital and a Center for Developmental Delays, where she served as Audiology Director.
Tabitha Parent-Buck, Au.D, is the Chair of Audiology at the Arizona School of Health Sciences, a Division of A. T. Still University of Health Sciences. She obtained her Master's Degree in Audiology from Purdue University, and she obtained her Doctor of Audiology degree from Baylor College of Medicine. Dr. Parent-Buck has practiced in a variety of clinical settings, provided academic instruction as an Assistant Professor for the Department of Speech and Hearing Sciences at the University of New Mexico, and worked as a sales representative and trainer in the hearing aid industry for AVR Sonovation.
Rebekah F. Cunningham, PhD
Assistant Professor in the Department of Audiology at A. T. Still University, the Arizona School of Health Sciences
Dr. Cunningham is currently an Assistant Professor in the Department of Audiology at A. T. Still University, the Arizona School of Health Sciences (ASHS). She is the Clinical Coordinator at ASHS and instructs residential as well as transitional students in a variety of topics, including OAEs, Evoked Potentials, Pediatric Audiology, Auditory Processing Disorders and Cochlear Implants. She has practiced privately and at several Children's Hospitals, as well as a Center for Developmental Delays, where she served as Audiology Director. She served for seven years on the American Academy of Audiology (AAA) Task Force on the Early Identification of Hearing Loss in Infants and Young Children. In addition, she served on the AAA Education Committee, chaired the Membership Committee of AAA for 3 years, and is currently on the AAA Board of Directors. Dr. Cunningham has designed, taught, and presented courses, as well as published, on the topics of assessment and management of children with hearing loss.
Tabitha Parent, AuD
Chair of Audiology, Arizona School of Health Sciences Distance Education Au.D. Program
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